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The U.S. Preventive Services Task Force (USPSTF) has published a final recommendation statement and summary on the screening for celiac disease in individuals without any signs or symptoms of the condition. This marks the first time the Task Force has made a statement on screening for celiac disease after having reviewed the available evidence.
Celiac disease is an immune disorder triggered by dietary gluten. Currently, it is estimated that 0.40%–0.95% of adults have celiac disease with a higher prevalence among non-Hispanic whites, people with a family history of celiac disease, and those with other autoimmune disorders.
For symptomatic patients aged >2 years, the standard diagnostic method is the tissue transglutaminase (tTG) IgA test followed by intestinal biopsy. The Task Force evaluated data on the accuracy of screening in asymptomatic adults, adolescents, and children. They also examined the potential benefits and harms of screening vs. not screening as well as targeted vs. universal screening. Moreover, the benefits and harms of treatment of screen-detected asymptomatic celiac disease were also reviewed. The Task Force analyzed contextual evidence regarding the prevalence of celiac disease among individuals without clear symptoms and the natural history of subclinical celiac disease.
Overall, the Task Force did not find enough evidence on the accuracy of screening for celiac disease in asymptomatic patients. Evidence on the potential benefits and harms of screening vs. not screening or targeted vs. universal screening in asymptomatic patients was also lacking. With regards to the potential benefits and harms of treating asymptomatic screen-detected disease vs. no treatment or treatment after clinical diagnosis, the evidence was also insufficient.
Task Force member Ann E. Kurth, PhD, CNM, MSN, MPH stated, “At this time, there simply is not enough evidence to determine the benefits and harms of screening for celiac disease in people without signs or symptoms of the condition, so the Task Force is calling for more research. Clinicians should use their judgment when deciding whom to screen.”
The final statement has been published in JAMA and the Task Force website.
For more information visit jamanetwork.com.
